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Prior Authorization Lookup


Please note:

  1. This tool is for outpatient services only.
  2. Inpatient services and nonparticipating providers always require prior authorization.
  3. This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all noncovered services (i.e., experimental procedures, cosmetic surgery, etc.)— refer to your  provider manual  for coverage/limitations.

*Services may be listed that are not covered benefits, whether they do or do not require precertification. Verify benefit coverage prior to rendering services.

To determine coverage of a particular service or procedure for a specific member:

Step 1:

Access eligibility and benefits information on the Availity Portal or call Provider Services at 1-844-462-0022.

Step 2:

Use the Prior Authorization tool above or within the Availity Portal.

Step 3:

If the service/procedure requires preauthorization, visit the Availity Portal.

To request authorizations:
  1. From the Availity home page, select Patient Registration from the top navigation.
  2. Select Auth/Referral Inquiry or Authorizations.

Provider tools & resources

Interested in becoming a provider in the Summit Community Care Network?

We look forward to working with you to provide quality service for our members.